Credentialing and Payer Contracting Lead (backed by Y Combinator, 5M+ ARR, 23M+ raised)

At Legion Health we believe everyone deserves fast affordable and world-class health care and were developing the AI infrastructure to deliver it ourselves at world scale.

Legion is building autonomous medical care (the AI doctor) starting with psychiatry. Our AI-native care-delivery platform currently automates 95% of the administrative work required for us to deliver direct patient care. We also recently became the first company ever to receive regulatory authorization to let AI prescribe psychiatric medications allowing us to not only collapse health cares admin costs but also its clinical labor costsshifting this industrys economics from humans to tokens.

Our technical moat is hard to copywe combine rich data production AI doctors in the loop and end-to-end care operations to deliver measurably better care to a clinically complex patient population. This has helped us produce tens of thousands of total visits in just 2 years all while holding ops costs flat and achieving industry-leading patient NPS and retention. While the last generation of healthcare startups made the existing system incrementally more efficient Legion is rebuilding full-stack care delivery from first principles. Our vision A 10X better patient experience thats higher quality less expensive and more scalable than ever before. And a 10X better clinician experience that frees our providers to focus on what matters most: caring for patients.

Legion Health is backed by Y Combinator leading venture capital firms and founders from Function Health Modern Health Everly Health Trusted Health Clipboard Health PatientPing Sesame Care Faire EasyPost and fuboTV.

Join us as we build the future of health care: faster higher-quality and more affordable powered by doctors and AI working together.

• Job Type: Contract

• Role Type: Credentialing & Payer Contracting Operations

• Ideal Experience Level: 2 years

• Location: Fully Remote

• Work Hours: 8:00 AM5:30 PM Central Time
  
  

Were looking for a highly organized detail-oriented Credentialing & Payer Contracting Coordinator to help clinicians move efficiently from onboarding to payer participation and billing readiness.

Youll coordinate provider credentialing recredentialing payer enrollment and contracting workflows across commercial and government health plans. Youll collect and maintain provider information submit applications follow up with payers track agreements and effective dates and ensure every open item reaches a clear resolution.

Were a fast-paced startup so the right person is proactive persistent adaptable and energized by building better processes as we scale. This is a non-clinical and non-legal role. You will not provide clinical or legal advice sign agreements negotiate outside approved parameters or attest on behalf of a provider without documented authorization.

• Coordinate initial credentialing payer enrollment and recredentialing for new and existing clinicians.

• Collect review and organize provider documentation including licenses DEA registrations where applicable malpractice coverage CVs education and work history board certifications W-9s NPIs taxonomy codes disclosures and attestations.

• Maintain accurate provider profiles in CAQH ProView NPPES PECOS state Medicaid systems commercial payer portals and internal tracking systems.

• Prepare submit and track enrollment applications roster additions demographic changes service-location updates reassignment requests terminations and payer requests for additional information.

• Follow up consistently with payer representatives through phone email portals and ticketing systems; document every interaction and escalate stalled or time-sensitive applications.

• Support the payer-contracting lifecycle including network-interest submissions contracting applications agreement intake fee-schedule organization redline tracking signature routing amendments and renewals.

• Route reimbursement legal and operational terms to the appropriate internal decision-makers for review and approval.

• Maintain a reliable source of truth for each provider and payer including application status participating plans contract status effective dates rates renewal dates outstanding items owners and next follow-up dates.

• Coordinate with provider operations revenue cycle finance legal and billing teams to confirm that credentialing contracting roster loading and billing setup are complete before a provider is marked ready to bill.

• Monitor licenses attestations recredentialing deadlines contract renewals and other expirations to prevent avoidable interruptions in payer participation.

• Investigate discrepancies across provider records payer portals contracts directories and internal systems and drive each issue through verified resolution.

• Track turnaround times aging applications upcoming deadlines payer bottlenecks and operational risks through clear weekly reporting.

• Identify recurring issues and improve workflows through better templates checklists documentation automation and escalation paths.

• Protect provider information and any patient information encountered by following Legions privacy security and access-control requirements.
  
  

• Proficient in spoken and written English.

• Exceptionally detail-oriented and able to identify inconsistencies across names addresses licenses NPIs TINs taxonomy codes and effective dates.

• Organized and comfortable managing multiple applications contracts deadlines and payer conversations without losing track of details.

• Persistent and professional when following up with payers and resolving delayed or incomplete applications.

• Proactive about identifying risks and escalating issues before they affect provider launches network participation or billing.

• A quick learner who can adapt to new payer requirements systems and internal processes.

• Comfortable working in a fast-paced startup where processes are continuously evolving.

• Skilled at maintaining clear documentation and ensuring every open item has an owner status next step and follow-up date.

• Trustworthy with sensitive information and disciplined about authorization attestations signatures and access controls.
  
  

• 2 years of experience in provider credentialing payer enrollment contract administration provider operations medical-staff services revenue-cycle operations or related healthcare administration.

• Hands-on experience with CAQH ProView NPPES PECOS Availity state Medicaid systems or commercial payer portals.

• Familiarity with initial credentialing recredentialing roster management provider demographic changes and payer effective-date verification.

• Experience supporting payer contracting fee-schedule review contract routing amendments or network-development workflows is strongly preferred.

• Behavioral health telehealth or multi-state provider-network experience is a plus.

• CPCS or another credentialing certification is a plus but not required.

• The most important qualifications are operational ownership accuracy persistent follow-through and clear communication.
  
  

• Hourly Compensation: $5$15 per hour

• Work Setup: Fully Remote